- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,006.15 / $11,691.40 / $15,366.50
| Facility | | $8,006.15 | $11,691.40 | $15,366.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,789.12 / $10,120.54 / $15,748.88
| Facility | | $5,789.12 | $10,120.54 | $15,748.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,253.33 / $8,967.20 / $14,985.57
| Facility | | $3,253.33 | $8,967.20 | $14,985.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,133.15 / $11,743.32 / $19,655.66
| Facility | | $8,133.15 | $11,743.32 | $19,655.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,070.65 / $13,105.70 / $19,135.39
| Facility | | $10,070.65 | $13,105.70 | $19,135.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,070.65 / $12,183.49 / $19,135.39
| Facility | | $10,070.65 | $12,183.49 | $19,135.39 |